But testing limited by lack of supplies
Editor’s note: The information in this article was accurate as of press time on March 24. Okanogan County Public health has since indicated that there is a confirmed case of COVID-19 in the county. All statistics surrounding this epidemic are expected to change as it continues. Click here to read a March 26, 2020 update.
Okanogan County was one of 10 counties not on the grim list of confirmed COVID-19 cases in Washington at the start of this week. But that enviable status comes with caveats.
“Due to limited testing supplies, at this time only people meeting very specific criteria are being tested for COVID-19 [the disease caused by the new coronavirus]. Because of this, it is possible that COVID-19 is circulating undetected in Okanogan County. Until we can do more widespread testing, we will not know for certain,” Okanogan County Public Health said in an update on Monday (March 23).
Health officials are candid about the numbers. A shortage of tests and personal protective equipment (PPE) for health care providers means they can’t get a true count of cases. Washington requested PPE from the Strategic National Stockpile but, because the state received only half its allocation, they’re rationing it, Family Health Centers CEO Jesús Hernández said this week. “They’re sending PPE to places with more cases, so it’s kind of a Catch-22,” he said.
Without enough tests, we’re unlikely to see the number of confirmed cases rise here, Hernández said.
“Public health experts agree that the true number of people who have been infected with COVID-19 in Washington greatly exceeds the number of COVID-19 infections that have been laboratory-confirmed,” the Washington Department of Health (DOH) said in its daily tally of cases. “It is very difficult to know exactly how many people in Washington have been infected to date since most people with COVID-19 experience mild illness and the ability to get tested is still not widely available.”
Confluence Health had to shut down a drive-through testing site in Wenatchee just days after it opened because of a bottleneck in getting results and to reserve tests for the most vulnerable populations, Confluence spokesperson Clint Strand said. Tests are now being done at Central Washington Hospital for people in high-risk groups.
The vast majority of tests have been negative. As of March 22, Okanogan County reported 90 tests for COVID-19. Thirty-seven came back negative and the rest are pending. In Washington, 93% of the people tested didn’t have COVID-19.
Cases are assigned to counties based on the patient’s primary residence, according to a public information officer with Washington’s COVID-19 Response Joint Information Center. On March 23, 117 of the 2,221 positive tests in Washington were still awaiting assignment to a county.
The coronavirus crisis has had one salutary effect on health care, as providers have accelerated the use of telemedicine for all patients — people with symptoms of COVID-19 and those who need to check in with a health care provider for a chronic condition or a medication refill, Hernández said.
Providers are still doing in-person exams when necessary, but the use of telemedicine protects clinicians and other patients and preserves the precious supply of PPE, Hernández said.
Family Health Centers have had telemedicine technology for some time, but it wasn’t widely used because Medicare and Medicaid wouldn’t pay for it — until they issued a temporary waiver during the COVID-19 pandemic, Hernández said. Private insurers had been somewhat more willing to pay for remote appointments before the pandemic.
While the technology has been available for a while, there’s a learning curve for providers and patients, particularly for those who aren’t tech-savvy, Hernández said. Ideally, both need an internet connection and a computer or smartphone for a video appointment, but some health care needs can be handled over the phone, he said.
Confluence Health launched “virtual visits” this week for patients with a mobile device or a computer with a camera and microphone. Providers may be able to treat a range of conditions virtually, including colds and flu, stomach viruses and bladder infections, according to a Confluence fact sheet. Emergencies will be routed to a clinic or emergency room.
Both Family Health Centers and Confluence Health are telling their patients to call first, rather than come to a clinic. If a patient has symptoms consistent with coronavirus, a health care provider will do a phone screening and arrange for a test if it’s deemed necessary. Many patients will be advised to self-isolate and monitor their condition, Hernández said.
Confluence Health’s Methow Valley Clinic in Winthrop posted a daunting “stop” sign on its door, telling patients with a fever and cough and those who’ve been exposed to someone with COVID-19 to return to their car and call the clinic instead. People with medical emergencies are directed to call 911 or go to the emergency room.
Anyone who shows up at a Family Health Centers clinic will be stopped at the door for screening, Hernández said. Family Health Centers shut down their dental clinics except for emergencies, another measure to save PPE for medical workers, he said.